Mobile Application for Self-Management in Schizophrenia: A Pilot Study

Raquel Simões De Almeida,Ana Couto,António Marques,Cristina Queirós,Constantino Martins

doi:10.1080/15228835.2018.1483859

Abstract

There is an urgent need to develop more effective interventions for psychotic disorders. Mobile Health solutions can address this emerging problem but needs more research. This study aims to present a new intervention and have some preliminary data about weCOPE. The sample is constituted by nine participants with a mean age of 38 years (±9.701), being 78% men, and with mean clinical follow-up time of 10 years. The intervention lasted eight weeks and was followed by each user's case manager. The data collection was carried out in two moments (before and after the application use), using six evaluation instruments: Recovery Assessment Scale, Empowerment Scale, General Self-Efficacy Scale, Social Support Satisfaction Scale, Personal and Social Performance Scale, and Positive and Negative Syndrome Scale. The data collected through these instruments were analyzed later through descriptive and inferential statistics. The majority of the results were significant and indicate that weCOPE may produce an improvement in symptoms (general psychopathology), empowerment, recovery, satisfaction with social support, self-efficacy, and personal and social functioning. Thus, this kind of mobile technologies for schizophrenia self-management may contribute to a subjective perception of the patient's better well-being and health condition.

Highlights

Schizophrenia is the most disabling mental illness and the costs of mental health services and burden are high compared to other diseases (Mueser & McGurk, 2004; Tandon, Keshava, & Nasrallah, 2008), due to its chronic and incapacitating course (Ganesh & Gupta, 2017; Mueser & McGurk, 2004; Owen, Sawa, & Mortensen, 2016)
On Stage 1 we used a sample of 102 individuals with schizophrenia, who completed an online survey reporting on their current use of mobile devices and interest in Mobile Health (mHealth) services
Recovery Assessment Scale (Corrigan et al, 2004; validated for Portuguese population by Sousa et al, 2009), a self-report scale with 24 items quoted on a 5-point Likert scale, meaning the higher the score the better recovery result. This scale comprehends five dimensions: personal confidence and hope, willingness to ask for help, goal and success orientation, reliance on others, and nondomination by symptoms

Summary

Introduction

Schizophrenia is the most disabling mental illness and the costs of mental health services and burden are high compared to other diseases (Mueser & McGurk, 2004; Tandon, Keshava, & Nasrallah, 2008), due to its chronic and incapacitating course (Ganesh & Gupta, 2017; Mueser & McGurk, 2004; Owen, Sawa, & Mortensen, 2016). There has been growing awareness about illness selfmanagement which plays an important role in empowering patients with chronic conditions, like schizophrenia, to manage their symptoms and to promote their recovery (Schie et al, 2016). Illness self-management can be defined as: One approach that was designed to engage individuals with schizophrenia as active agents in their own treatment by teaching them to self-monitor their ongoing clinical status, avoid high-risk stressors, stay on track with their medications, and use various coping and compensatory strategies when symptoms and other problems associated with their psychiatric condition emerge. Literature offers different general definitions of self-management regarding schizophrenia, the definitions agree on the core elements (Schie et al, 2016), which are, according to WHO - Regional Office for Europe (2010, p. 2): “problem solving, goal setting, identifying triggers and indicators of deteriorating health and responding to these themselves before relying on clinician-led intervention.” illness self-management can be defined as: One approach that was designed to engage individuals with schizophrenia as active agents in their own treatment by teaching them to self-monitor their ongoing clinical status, avoid high-risk stressors, stay on track with their medications, and use various coping and compensatory strategies when symptoms and other problems associated with their psychiatric condition emerge. (Ben-Zeev et al, 2013, p. 2)

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Conclusion